Nose fillers and the non-surgical rhinoplasty

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Truths and Myths

There is a growing trend for patients to seek improvement to the shape of the nose through non-surgical means.  Through the use of commercially available intra-dermal fillers, some practitioners treat patients in an office setting to change the shape of the nose.  Although on surface, this type of treatment, sometimes called “non-surgical rhinoplasty”, would seem to be much more convenient than undergoing a surgery, there are many misconceptions about the procedure as listed below.

  1. Non-surgical rhinoplasty can create the same changes as surgical rhinoplasty. 

Fillers in the nose are limited to increasing volume in targeted areas.  For example, a filler may be injected above a hump on the bridge of the nose to camouflage the prominence of the hump.  Fillers cannot narrow a nose, reduce the bulk of any structures, or change the true shape of the nose.  Fillers simply add volume around the existing nose.  Surgical rhinoplasty gives the surgeon far more control over the underlying structure of the nose to make a much greater range of possible improvements.  

  1. Non-surgical rhinoplasty carries no risks.

Injectable fillers carry a risk of vascular complications.  If the filler is inadvertently injected into an artery, the overlying skin can lose blood supply and die, potentially causing a permanent scar or deformity.  If the filler enters a blood vessel and the filler migrates (embolizes), it can cause occlusion of a distant artery and create more devastating damage.  A rare complication of filler placed in the upper nasal bridge or space between the eyes is embolization to the optic vessels, causing blindness.  Although these complications are rare, they are devastating with permanent consequences. 

  1. Non-surgical rhinoplasty can create permanent or long-term results.

All FDA approved commercially available fillers are reabsorbed by the body in 6-12 months following treatment. 

  1. Fillers can be placed into any area of the nose with equivalent effectiveness and risk.

Fillers placed into areas of high soft tissue density (tip, nostril base) pose a much greater risk for vascular occlusion.  In addition, fillers are not as reliable in creating a predictable effect when placed in areas where there is not a firm foundation (such as the bridge).

  1. Non-surgical rhinoplasty is a more economical option than surgery

Because fillers need to be re-injected every 6-12 months, the costs accumulate and eventually exceed the one time cost of a surgical alternative.

  1. Filler is a good option to treat contour irregularities following previous surgical rhinoplasty

Using filler to fill in depression or irregularities following previous rhinoplasty is risky.  There is a greater risk of vascular compromise due to thinning of the skin and scar tissue formation from surgery.  This is especially true with thin skin individuals.


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Bay Area Facial Plastic Surgeon